Understanding organizational perspectives from clinical research stakeholders involved in recruitment for biopharmaceutical-sponsored clinical trials in the United States: Recommendations for organizational initiatives to improve access and inclusivity in clinical research.

Background: Equitable representation of racially and ethnically diverse subpopulations in clinical trials continues to be a problem, and trial participants do not always reflect the demographics of the population that the investigational product will be used to treat. The imperativeness of equitable representation of clinically relevant populations in clinical trials has implications for improving health outcomes, increasing knowledge about the safety and efficacy of new treatments across a wider population, and broadening access to innovative treatment options offered in clinical trials. Methods: The purpose of this study was to understand organizational elements that are involved in the active implementation of racially and ethnically diverse inclusive recruitment practices for biopharmaceutical-funded trials in the United States. Semi-structured, in-depth interviews were used in this qualitative study. The interview guide was designed to explore the perceptions, practices and experiences of 15 clinical research site professionals related to recruiting diverse trial participants. Data analysis utilized an inductive coding process. Results: Five themes were identified pertaining to the actual implementation of inclusive recruitment practices that provided explanations for organizational components: 1) provision of culturally appropriate, general disease and clinical trial education 2) organizational structure tailored for diverse recruitment 3) strong sense of mission related to improving healthcare through clinical research 4) culture of inclusion 5) inclusive recruitment practices evolving based on learning. Conclusion: The findings from this study offer insight into improving access to clinical trials by focusing on organizational change initiatives.

Prevalence of burnout among doctors of chiropractic in the northeastern United States.

OBJECTIVE: The purpose of this study was to measure the prevalence of burnout among doctors of chiropractic (DCs) in the New York, New Jersey, and Pennsylvania geographical region and compare these results with burnout data from other health care professions. METHODS: This exploratory study applied cross-sectional data collection methods. Using nonprobability convenience sampling, a New York-New Jersey-Pennsylvania chiropractic governance body provided contact information of a randomized sample of licensed DCs from their membership directory. Participants included any DC licensed to practice chiropractic whose primary occupation encompassed the chiropractic profession. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and a demographic questionnaire were e-mailed to a randomized sample of licensed DCs. RESULTS: Of the 772 surveys deployed, 90 returned the survey with usable data. Nearly 40% of the DCs reported a moderate (24%) or high (18%) level of emotional exhaustion, whereas the majority of respondents scored a high (72%) level of personal accomplishment. In total, only 2 participants (2%) met the criteria for high burnout, whereas 42 participants (47%) were low. Statistically significant relationships (P < .001) were found between burnout subscales and the effect of time dedicated to administrative duties, the type of practice setting, the varying chiropractic philosophical perspectives, the public's opinion of chiropractic, and the effect of suffering from a work-related injury. When compared with data from previously published studies using the MBI-HSS for other health professions (ie, medical, nursing, physical therapy, occupational therapy, and dentistry), the values for DCs were significantly lower. CONCLUSIONS: The sample of DCs in this study fared more favorably on all 3 dimensions of burnout. They reported lower emotional exhaustion and depersonalization scores and higher personal accomplishment scores than their medical, nursing, physical therapy, occupational therapy, and dentistry colleagues who have been evaluated using the MBI-HSS. However, the levels of emotional exhaustion remain a concern for this professional group.

Leading a multigenerational workforce: strategies for attracting and retaining millennials.

Over the past several years, leaders in healthcare have noticed an increase in generational tension among employees, most often focused on the attitudes and behaviors of the arriving millennials (generation Y). While these employee relations issues were a nuisance, they rarely rose to the level of a priority demanding leadership intervention. Some leaders, in fact, hoped that the issues would resolve themselves as these young employees settled in and learned that they had to demonstrate new behaviors to be successful in the workplace. Most organizations adopted this wait-and-see attitude. Not so today. As the boomer generation has begun its exodus from the workplace, organizations are increasingly looking at the millennials as not a problem but a solution to the workplace manpower transition that is under way. Our problem is that we don't yet know how best to lead such a diverse, multigenerational workforce. This article examines the generational topic and provides advice concerning a variety of changes that leaders may implement to advance their organization's ability to attract and to retain the millennials.

Does the mind map learning strategy facilitate information retrieval and critical thinking in medical students?

BACKGROUND: A learning strategy underutilized in medical education is mind mapping. Mind maps are multi-sensory tools that may help medical students organize, integrate, and retain information. Recent work suggests that using mind mapping as a note-taking strategy facilitates critical thinking. The purpose of this study was to investigate whether a relationship existed between mind mapping and critical thinking, as measured by the Health Sciences Reasoning Test (HSRT), and whether a relationship existed between mind mapping and recall of domain-based information. METHODS: In this quasi-experimental study, 131 first-year medical students were randomly assigned to a standard note-taking (SNT) group or mind map (MM) group during orientation. Subjects were given a demographic survey and pre-HSRT. They were then given an unfamiliar text passage, a pre-quiz based upon the passage, and a 30-minute break, during which time subjects in the MM group were given a presentation on mind mapping. After the break, subjects were given the same passage and wrote notes based on their group (SNT or MM) assignment. A post-quiz based upon the passage was administered, followed by a post-HSRT. Differences in mean pre- and post-quiz scores between groups were analyzed using independent samples t-tests, whereas differences in mean pre- and post-HSRT total scores and subscores between groups were analyzed using ANOVA. Mind map depth was assessed using the Mind Map Assessment Rubric (MMAR). RESULTS: There were no significant differences in mean scores on both the pre- and post-quizzes between note-taking groups. And, no significant differences were found between pre- and post-HSRT mean total scores and subscores. CONCLUSIONS: Although mind mapping was not found to increase short-term recall of domain-based information or critical thinking compared to SNT, a brief introduction to mind mapping allowed novice MM subjects to perform similarly to SNT subjects. This demonstrates that medical students using mind maps can successfully retrieve information in the short term, and does not put them at a disadvantage compared to SNT students. Future studies should explore longitudinal effects of mind-map proficiency training on both short- and long-term information retrieval and critical thinking.

Experiences that develop the ability to think strategically.

The ability to think strategically is an admired and a sought-after leadership requirement, yet we know little about how it develops. The purpose of this study is to identify specific experiences that contribute to the development of an individual's ability to think strategically. We identified eight work experiences, including different types of organizational projects, processes, and relationships, that contribute to an individual's strategic thinking ability. We also delineate specific characteristics material to each experience. These characteristics indicate that considerable time and focus are required to develop the ability to think strategically. In addition, the experiences are not all accessed equally: Women are less likely to have nonrelational experiences, while chief executive officers are more likely to have the most challenging ones. In addition, we found differences regarding work-related continuing education activities. Respondents rated nonhealthcare conferences and reading behind all other identified experiences that contribute to strategic thinking ability. Individuals can implement several strategies to improve their strategic thinking ability, including deliberately incorporating the requisite experiences into their development plans, ensuring that the experiences incorporate the required characteristics, and improving the benefit received from attending educational programs in nonhealthcare industries. Organizations can implement several strategies to ensure the experiences are as effective as possible, such as appraising gender differences across the experiences and reviewing the organization's strategic planning processes for the characteristics that best encourage strategic thinking.